Affectionate killer: Where does hepatitis come from and how to cure it
We have already told how to take care of the health of the liver. and what problems can those who believe that she can endure. But what to do if the moment is missed, and the complexion became suspicious? Together with the Vice President of the Russian Society for the Study of the Liver (ROPIP), a gastroenterologist, and a hepatologist, Marina Mayevskaya, we understand what causes hepatitis and how to deal with the disease.
What is hepatitis
The name of the disease is collective and refers to inflammation of the liver, as a result of which normal liver cells (hepatocytes) die. And when there are more dead hepatocytes than new normal cells, the process of scarring tissue begins (fibrosis), which over time can lead to cirrhosis or liver cancer. The disease can occur both in acute and in chronic.
The common beliefs about hepatitis are based on the myth that only those who put themselves at additional risk face a problem, for example, neglecting protected sex or using intravenous drugs. According to this logic, if you lead a "pious" lifestyle, nothing will happen, and hepatitis will bypass. These judgments are justified only in part, but in fact everything is much more complicated: there are a lot of types of hepatitis, and the causes of its occurrence are also very different.
Hepatitis can actually be caused by a viral infection, and then you need to talk about viruses of types A, B, C (people call him "affectionate killer"), D, E. Sometimes experts separate G type, despite the fact that it is almost identical C and, as it is believed (this species is not well understood), extends the same. However, not only and not so many viruses can provoke the development of hepatitis. Sometimes behind all is non-alcoholic fatty disease. In the USA alone, for example, up to 40% of the adult population is affected; for comparison - in 2015, hepatitis B virus infection was recorded in 3.5% of the population. Non-alcoholic fatty disease can result in the so-called non-alcoholic steatohepatitis (faced by 3 to 12% of Americans), in this case, the excess fat accumulated in the liver cells leads to inflammation. This disease is associated with diabetes, a violation of lipid metabolism or increased body mass, but other causes are not excluded.
Since the liver works as a filter, toxins can cause special damage. And here, first of all, you need to remember about alcohol - in one of the studies alcoholic liver disease was found in 6.9% of the 5,000 residents of Moscow. Do not write off drugs (in 10% of cases of acute hepatitis it is to blame them) and dietary supplements.
Some studies complement the range of exposure to toxic chemicals at work (although it is difficult to judge whether they can indeed be the root cause of toxic hepatitis). In addition, it makes sense to use energy drinks with caution: there is a case of acute hepatitis in a healthy fifty-year-old man who drank four to five cans daily for three weeks. Mayevskaya also says that sometimes toxic hepatitis occurs in people (most often young men) who inject drugs on the basis of testosterone to accelerate muscle growth. Testosterone significantly affects the liver, and such patients get to a hepatologist with jaundice and pruritus.
Hepatitis can also be autoimmune, when the body perceives liver cells as something alien and tries to destroy them. This problem is more common in women; and although it is impossible to completely cure autoimmune hepatitis, it is successfully controlled with the help of special therapy, which suppresses the inflammatory process and even allows the liver to recover to some extent.
How hepatitis viruses spread
When traveling, for example, in some parts of Asia and Africa, where health standards are poorly observed, viruses of type A or E can be picked up. Hepatitis caused by these viruses is a typical “dirty hands disease”; infection occurs through the fecal-oral route through poorly processed food, polluted water or unwashed hands. According to WHO, in 2010 there were up to 1.4 million cases of hepatitis A virus infection every year.
Hepatitis B virus spreads through the blood and during sexual intercourse. In everyday life, its carriers do not pose a threat to the environment, but it is important that a person infected with a virus of type B has his own manicure accessories, a razor, and so on. For the same reason, concerns about the safety of nail services are absolutely justified: you need to make sure that the salon carefully sterilizes the tools, and do not trust the treatment with ultraviolet light - it does not destroy hepatitis viruses.
Type C and D viruses are also transmitted through blood and related subjects. The particular danger of infection with a type C virus is that it often turns into a chronic form, not completely cured (75-85% of newly infected acquire it). In 2016, WHO reported that 130-150 million people have chronic hepatitis C virus infection, and chronic B-type virus infection is even more common - 240 million people have it in the world.
How to detect inflammation or infection
Hepatitis viruses are cunning: most often their presence does not manifest itself. According to the latest data, up to 90% of people with hepatitis B infection are not even aware of it. Hepatitis itself can also proceed implicitly and manifest itself only by weakness and increased fatigue, which can be easily attributed to lack of sleep. It is necessary to donate blood to check for viruses, if you had unprotected sex or had to be manipulated with blood in dubious conditions. In addition, screening for these infections is usually carried out for pregnant women and for people with certain risk factors.
Learn about liver inflammation can be done if you make a biochemical blood test. Hepatologists conditionally distinguish the so-called hepatic panel, or the panel of parameters of the function of the liver - these are indicators, the change of which indicates that something went wrong. For example, the increased activity of transaminases (liver enzymes) ALT or AST suggests that an inflammatory process has begun. There are other markers - GGTP and alkaline phosphatase, which are used to evaluate damage to the cells of the organ. And experts are guided by the level of bilirubin in the blood - it is its increase that can lead to yellowing of the skin and whites of the eyes.
Yellowing of the eyes and skin is one of the most obvious symptoms, but jaundice does not necessarily indicate hepatitis. The problem may be in violation of the outflow of bile or destruction of blood cells - be that as it may, with this symptom you just need to run to the doctor. Jaundice can occur in acute cases - if a recent infection with the hepatitis virus or liver inflammation is triggered by medication - and in severe stages of alcohol or toxic hepatitis.
How is hepatitis treated
There is no special treatment that removes types A and E viruses; Supportive therapy is usually given to help cure inflammation, and the body can cope with viruses independently. Hepatitis A caused by virus A is very rarely fatal, and most infected people recover, gaining further immunity against the virus; while type E virus causes 3.3% of the total number of deaths from viral hepatitis. With viruses of types B and C, everything is more complicated: the body itself cannot get rid of them. To eliminate the hepatitis C virus, there are now very effective antiviral drugs of direct action, the undesirable effects of which are easily tolerated (or they may not even appear).
With a type B virus, the situation is not so rosy - despite the fact that the drugs used destroy the infection in the blood serum, if the therapy is canceled, the pathogens can be reactivated again, causing inflammation of the liver. True, only 30% of patients with hepatitis B virus need treatment, the remaining 70% need people with inactive carrier, there is little pathogen in their blood, there is no active inflammation in the liver, and they do not need treatment, just need to monitor the situation.
Treating non-viral hepatitis is somewhat easier. In the case of autoimmune hepatitis, most patients respond well to the standard treatment protocol, and with proper treatment, remission can be achieved in 80% of cases. In the treatment of alcoholic hepatitis key to success in the rejection of alcohol. Treatment of liver inflammation caused by toxins or drugs is based on the principle of eliminating the cause.
How to protect yourself from hepatitis
It is possible to prevent the development of most types of hepatitis (except, perhaps, autoimmune). Do not neglect vaccination against type A virus if you go to a place where everything is difficult with hygiene issues. In addition, in places with dubious sanitation, wash your hands more thoroughly, buy only bottled water and watch what you eat.
For the prevention of hepatitis B virus infection, there are many high-quality vaccines, and in Russia this vaccine is included in the National Calendar. It is also important to remember the basics of safe sex and not share personal hygiene items with anyone. It is much more difficult to protect oneself from the hepatitis C virus - there is no vaccine against it yet. The risk of developing this type of hepatitis B significantly increases with drug use, and the rest of the rules do not change: caution and careful disinfection of public goods are still a priority.
Photo:Kateryna_Kon - stock.adobe.com (1, 2, 3)
